Premature rupture of membranes (PROM) affects approximately 10% of pregnant women. PROM, when unattended or mismanaged may lead to severe maternal and neonatal complications. The present study aims to study the subsequent course of pregnancy and evaluate the maternal, and neonatal morbidity and mortality in PROM patients admitted in our hospital. To study the outcome of PROM and assess the maternal and perinatal morbidity and mortality. It was a prospective observational study. All the patients of PROM admitted in hospital and considered based on inclusion and exclusion criteria were included in the study. They were induced with either oxytocin or misoprostol depending on their Bishops score. In the group of patients, where PROM delivery interval >18 hours were found to have more maternal complications like puerperal sepsis, chorioamnionitis, wound gape, paralytic ileus, and more neonatal complications like jaundice, sepsis. In our study, maternal morbidity was directly related to the PROM delivery interval. Thus, women diagnosed with PROM should be hospitalised early or referred early to tertiary hospital and actively managed and followed up till delivery. Timely referral and timely intervention can further improve perinatal outcome.

No abstract

IntroductionPolycystic ovary syndrome (PCOS) is a common endocrine disorder in women of childbearing age in India, which often presents as menstrual irregularities, infertility, acanthosis nigricans, etc. Metabolic disturbances associated with PCOS predispose patients to cardiovascular diseases, which may be avoided by effective management. The aim of the current study was to evaluate the role of lifestyle modification (LSM) and metformin in PCOS management. MethodsThis is a retrospective cohort study conducted among 130 PCOS patients who attended the outpatient department of the tertiary care hospital in central India from October 2019 to March 2020. The study describes the effect of a combined package of LSM (physical exercise and dietary changes) and metformin on anthropometric, clinical, and biochemical parameters at three and six months. ResultsOut of the total 130 women, 12 were lost to follow-up and were omitted from further analysis. At six months of the treatment package (LSM, metformin, and enhanced adherence counseling (EAC)), a significant decrease was seen in body mass index, blood sugar, follicle-stimulating hormone, luteinizing hormone, and insulin. Following the intervention, the menstruation cycle became regular in 91% of the women while volume, theca, and appearance of polycystic ovaries on ultrasound decreased in 86% of women. Insulin resistance (IR) and hyperinsulinemia are the major causes of pathophysiological changes associated with PCOS. Metformin along with LSM primarily acts by decreasing IR, while EAC ensures treatment compliance. ConclusionMetformin along with LSM in the form of calories restricted, high-protein diet, and physical activity reduce IR and hyperandrogenaemia, resulting in improved anthropometric, glycemic indices, hormonal profiles, and features of hyperandrogenaemia. The combined therapy is beneficial to 85-90% of women with PCOS.

Hysterectomy is the most common gynaecological surgery and there are different techniques of performing hysterectomy. With the advent of laparoscopic technology, laparoscopic hysterectomy (LH) is rapidly gaining its ground. However, every surgery has its complications which are specific but also depends on various factors such as surgical skills and experience of surgeons, levels of operative laparoscopy and patient populations. Aims and Objective: In this study, we evaluated the complications of total laparoscopic hysterectomy (TLH) and analysed the trend of complications, intraoperative and post-operative, over a period of time. Methods: It was a retrospective study conducted in the private care setting. All women who underwent hysterectomy for benign conditions from a 1 January 2003 to 31 December 2017, (15 years) were included in this study. A total of 3272 patients were operated during this period. All surgeries were performed by a single surgeon. Results: Intraoperative complications that occurred during surgery during the study period were 3 cases (0.09%) had bladder injury, 3 cases (0.09%) had bowel injury, 1 case (0.03%) had internal iliac vessel bleeding and 1 case(0.03%) needed conversion to vaginal hysterectomy due to cautery failure and post operative complications were 90 cases (2.75%) had vault bleeding, 2 cases (0.06%) had intestinal obstruction, 5 cases (0.15%) had paralytic ileus, 1 case (0.03%) had vesicovaginal fistula, 1 case(0.03%) had ureterovaginal fistula and 1 case (0.03%) had peritonitis. Conclusions: TLH is a very effective, patient-friendly and safe technique in the hands of experienced surgeons giving good quality of life to patients postoperatively.

Background: Deficiency of Vitamin D or 25(OH) cholecalciferol is a severe health problem worldwide. Vitamin D is essential for calcium and bone metabolism and protects against various autoimmune disorders, cardiovascular diseases, chronic infections, cancers, and infertility. It also plays a vital role in pregnancy. During pregnancy, the fetus acquires their vitamin D from their mother and r the first few months of life after delivery, particularly in breastfed infants. Deficiency of Vitamin D in infants can lead to rickets, respiratory infections, allergic diseases, heart failure. Aims and Objective: To investigate the prevalence of vitamin D deficiency in the postpartum period and to study its relation with the sociodemographic characteristics of the patients. Materials and Methods: This was cross-sectional observational study was conducted over one year. Sociodemographic characters and serum concentrations of vitamin D in the 25(OH)D were compared. Results: To a total of 550 patients were enrolled. The mean age of patients was 26.5 years, around 58% of patients were from the peri-urban area, maximum number of patients were primiparous. Around 90% of patients did not have any sun exposure on a regular basis. Around 59% of enrolled patients were either unbooked or had only one antenatal visit. The mean plasma concentration of 25(OH)D in postpartum patients was 27.6ng/mL. No association was found between sociodemographic factors studied and vitamin D concentration. Conclusion: This study showed the higher prevalence of vitamin D deficiency in India's postpartum patients despite having abundant sunlight and identifies the need for supplementation of vitamin D in pregnancy and postpartum. This supplementation has to be followed routinely in hospitals in obstetric management protocol.